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Individual

ANUPAMA KURIAKOSE JACOB

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHARM D

Contact information

Practice address
12050 BUSTLETON AVE, PHILADELPHIA, PA 19116-2108
(215) 673-0937
Mailing address
12050 BUSTLETON AVE, PHILADELPHIA, PA 19116-2108

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP439334
PA

Other

Enumeration date
09/20/2011
Last updated
09/20/2011
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